There are a number of drugs that reduce intra-ocular pressure by various mechanisms, with a topical beta-blocker or prostaglandin being first choice treatment options. If glaucoma progresses or intra-ocular pressure cannot be reduced sufficiently consider an alternative class of topical treatment or a combination of drug classes.
Understanding quantity required:
There are 20 drops in 1ml of medication. Therefore a 5 ml bottle has 100 doses.
One drop is sufficient for one dose and contains more volume than the eye can hold. Closing the eye and pressing on the tear duct for 1 minute can deliver 50% improved absorption of active ingredient. A patient should wait 5 minutes between different eye medications.
Because prostaglandins (Latanoprost / bimatoprost / tafluprost / travoprost) are administered once daily, bottles are only 2.5ml or 3ml
Tablets and MR capsules - Used when IOP uncontrolled on maximum tolerated topical treatment
Injection - Primary acute angle closure. Open and narrow angle glaucoma
Pack |
---|
28 capsule |
30 capsule |
20 capsule |
Pack |
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112 tablet |
120 tablet |
100 tablet |
Pack |
---|
1 vial |
Pack |
---|
24 unit dose |
Pack |
---|
5 ml |
Pack |
---|
5 ml |
Pack |
---|
50 unit dose |
Bimatoprost 300mcg/ml eye drops preservative free (multidose container) is the preferred choice for newly initiated patients
Bimatoprost 100mcg/ml eye drops is second line
The brand Bimi® (Bimatoprost 300mcg/ml eye drops preservative free (multidose container)) shelf life extended to 90 days
Pack |
---|
3 ml |
9 ml |
Pack |
---|
3 ml |
9 ml |
Pack |
---|
30 unit dose |
Pack |
---|
3 ml |
9 ml |
2nd choice - to be considered where there is intolerance to dorzolamide or it has not been effective.
Administration twice a day
Pack |
---|
5 ml |
Second line treatment as per NICE guidelines
Pack |
---|
5 ml |
Usual administration:
Three times a day (mono therapy)
Twice a day (dual therapy with topical beta-blocker)
Dorzolamide 20mg/ml eye drops preservative free are more cost effective than preservative free 0.2ml unit dose drops
Pack |
---|
5 ml |
Pack |
---|
60 unit dose |
Pack |
---|
5 ml |
Dorzolamide 20mg/ml / timolol 5mg/ml eye drops preservative free 5ml and 10ml bottles are the preferred choice for newly initiated patient.
Cosopt iMulti is not recommended as it is not cost-effective
Pack |
---|
5 ml |
Pack |
---|
60 unit dose |
Pack |
---|
5 ml |
10 ml |
1st line choice
Administration once a day (evening)
Pack |
---|
3 ml |
Pack |
---|
30 unit dose |
90 unit dose |
To be administered three or four times a day. Excipients depend on manufacturer
Pack |
---|
10 ml |
1 ml |
Pack |
---|
10 ml |
1 ml |
Pack |
---|
10 ml |
Pack |
---|
10 ml |
Pack |
---|
20 unit dose |
Reserved for patients with preservative allergy where latanoprost and travoprost have already been tried
Apply once a day, preferably in the evening
Pack |
---|
30 unit dose |
Pack |
---|
5 ml |
Pack |
---|
30 unit dose |
Pack |
---|
3 ml |
Pack |
---|
5 ml |
Pack |
---|
30 unit dose |
Pack |
---|
3 ml |
Pack |
---|
30 unit dose |